Legislative Activity

Senate Committee Takes Shot At Vaccine-Preventable Diseases

This week, as the country faces a well-publicized outbreak of measles, the Senate Committee on Health, Education, Labor, and Pensions (HELP) will hold a hearing to discuss the reemergence of vaccine-preventable diseases. The media has publicized the measles outbreak after visitors and workers in California contracted the virus at Disneyland and a college student with measles traveled by train through New York State. In an interview, President Barack Obama urged parents to get their children vaccinated, stating that the science behind vaccinations is “indisputable.”

Actions On ACA Continue

After the House passed H.R. 22, the Hire More Heroes Act of 2015, on January 6, the Senate Committee on Finance held a mark-up of its own bill, S. 12, on January 28. The bill excludes veterans from the Affordable Care Act’s employer mandate count. This past week, the Congressional Budget Office (CBO) stated that the Senate’s bill would increase the deficit by $858 million over the next ten years. CBO explained that the bill does not impact a person’s eligibility for coverage or the cost of such coverage. However, the legislation would release employers from paying monetary penalties, thus providing less revenue.

This past week, Sen. Richard Burr (R-NC), Senate Committee on Finance Chairman Orrin Hatch (R-UT), and House Committee on Energy and Commerce Chairman Fred Upton (R-MI) unveiled their plan to replace Obamacare. The Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act includes policies to: repeal the individual and employer mandate; prohibit lifetime limits on the dollar value of benefits for participants; provide more state regulation of health insurance; require health plans to offer dependent coverage up to age 26; guarantee health coverage renewability; prohibit coverage decisions based on a pre-existing condition only if the consumer was continuously enrolled in a health plan; establish a health financing office at the U.S. Department of Treasury charged with administering health tax credits; adopt Medicaid capped allotment for states; reauthorize Health Opportunity Accounts for Medicaid beneficiaries; reform medical malpractice issues; increase price transparency; and cap the tax exclusion for an employee’s health coverage at $12,000 for an individual and $30,000 for a family. It is widely believed that should the plan reach President Obama’s desk, the President would veto it.

Health Cybersecurity Draws Scrutiny

Senate Committee on Health, Education, Labor, and Pensions (HELP) Committee Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) jointly announced an initiative to examine the security of health information technology (IT) and the health industry’s readiness for cyber threats. The effort will focus on electronic health records, hospital networks, insurance records, and network-connected medical devices. Staff meetings on the topic began in January. Anthem, Inc., the country’s second-largest health insurer, announced this week that hackers accessed a database containing personal information of about 80 million individuals. President Obama called attention to cybersecurity in his State of the Union address in January.

This Week’s Hearings:

• Tuesday, February 10: The Senate Committee on Health, Education, Labor, and Pensions (HELP) will hold a hearing titled “The Reemergence of Vaccine-Preventable Diseases: Exploring the Public Health Successes and Challenges.”

• Wednesday, February 11: The House Committee on Appropriations will hold two hearings: the Subcommittee on Interior, Environment, and Related Agencies will hold a hearing titled “Indian Health Service Budget” and the Subcommittee on State, Foreign Operations, and Related Programs will hold an oversight hearing titled “Funding to Prevent, Prepare for, and Respond to the Ebola Virus Disease Outbreak.” The House Committee on Energy and Commerce will hold two hearings: the Subcommittee on Oversight and Investigations will hold a hearing titled “Federal Efforts on Mental Health: Why Greater HHS Leadership is Needed” and the Subcommittee on Health will hold a hearing titled “Examining ICD-10 Implementation.”

Regulatory Activity

FDA Commissioner Hamburg To Leave

On Thursday, February 5, Food and Drug Administration (FDA) Commissioner Margaret Hamburg announced that she will leave the agency at the end of March. She was nominated for the position in 2009. In her place, Stephen Ostroff, the FDA’s Chief Scientist, will serve as acting commissioner.

GAO Releases Report On ICD-10

On Friday, February 7, the U.S. Government Accountability Office (GAO) released a report titled “International Classification of Diseases: CMS’s Efforts to Prepare for the New Version of the Disease and Procedure Codes.” As of October 1, 2015, covered entities will be required to transition from the ninth edition of the International Classification of Diseases (ICD-9) to the tenth edition (ICD-10). In preparation, Senate Finance Committee Chairman Orrin Hatch (R-UT) and Ranking Member Ron Wyden (D-OR) requested that GAO review efforts by the Centers for Medicare and Medicaid Services (CMS) to support covered entities during the transition, and to evaluate stakeholder’s most significant concerns and recommendations.

GAO found that CMS has taken a number of efforts to prepare for the ICD-10 transition, including developing educational materials, conducting outreach efforts, and providing technical assistance. Additionally, the report concluded that while stakeholders identified several areas of concern about the transition to ICD-10, CMS has taken steps to address those concerns. For example, in response to recommendations that CMS do more to engage covered entities through non-electronic methods, CMS held biweekly stakeholder collaboration meetings and distributed print advertisements.

CMS Issues Final Rule On Private Medicare Plans And Prescription Drug Coverage

On Friday, February 6, CMS published a final rule titled “Medicare Program; Contract Year 2016 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefits Programs.” The rule amends the Medicare Advantage program (Part C) and Medicare Prescription Drug Benefit Program (Part D) to clarify program requirements, implement statutory requirements, improve and strengthen efficiencies and beneficiary protections, improve payment accuracy, and make technical changes. The rule addresses the following major provisions: changes to audit and inspection authority; enrollment eligibility for individuals not lawfully present in the United States; business continuity for Medicare Advantage organizations and prescription drug plan sponsors; and efficient dispensing in long term care facilities and other changes.